Rich countries tap into COVAX supply while poor wait for blows



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An international coronavirus vaccine-sharing system was supposed to ensure that low- and middle-income countries could get doses without being the last in line and at the mercy of unreliable donations.

It didn’t work that way. At the end of June alone, the initiative known as COVAX sent some 530,000 doses to Britain, more than double the amount sent that month to the entire African continent. .

Under COVAX, countries were supposed to donate money so that vaccines could be put aside, both as donations to poor countries and as an insurance policy for the wealthy to buy doses if theirs failed. Some rich countries, including those in the European Union, calculated that they had more than enough doses available through bilateral agreements and gave up their allocated COVAX doses to poorer countries.

But others, including Britain, have themselves tapped into the meager supply of COVAX doses, despite being among the countries that had reserved most of the vaccines available in the world. Meanwhile, billions of people in poor countries have yet to receive a single dose.

The result is that the poorest countries found themselves in exactly the predicament that COVAX was supposed to avoid: depending on the whims and policies of rich countries for donations, as they have so often been in the past. And in many cases, rich countries don’t want to make large donations until they have completed immunizing all of their citizens who might possibly want a dose, a process that still goes on.

“If we had tried to refuse vaccines in some parts of the world, could we have done worse than today? asked Dr Bruce Aylward, senior adviser at the World Health Organization, in a public session on vaccine equity.

Other wealthy countries that have recently received paid doses through COVAX include Qatar, Bahrain and Saudi Arabia, all of which have relatively high vaccination rates and other means of acquiring vaccines. Qatar has pledged to donate 1.4 million doses of vaccine and has already shipped more of the 74,000 received doses of COVAX.

The United States has never received doses via COVAX, although Canada, Australia and New Zealand have. Canada has received so much criticism for accepting COVAX shipments that it has said it will not ask for more.

In the meantime, Venezuela has not yet received any of its doses allocated by COVAX. Haiti received less than half of what it was allocated, Syria about a tenth. In some cases, officials say, doses were not sent because countries did not have plans to distribute them.

UK authorities have confirmed that the UK had received around 539,000 doses of the vaccine by the end of June and had the option to purchase 27 million additional vaccines through COVAX.

“The government is a strong supporter of COVAX,” said the UK, describing the initiative as a mechanism for all countries to get vaccines, not just those in need of donations. He declined to explain why he chose to receive these doses despite private agreements that reserved eight injections for every UK resident.

Brook Baker, a law professor at Northeastern University specializing in access to medicines, said it was unacceptable for rich countries to tap into COVAX vaccine supplies when more than 90 developing countries had virtually no access. . The largest supplier of COVAX, the Serum Institute of India, stopped sharing vaccines in April to deal with a surge of cases on the subcontinent.

Although the number of vaccines purchased by rich countries like Britain through COVAX is relatively small, the extremely limited global supply means these purchases result in fewer vaccines for poor countries. So far, the initiative has delivered less than 10% of the promised doses.

COVAX is managed by the World Health Organization, the Gavi Vaccine Alliance, and the Coalition for Epidemic Preparedness Innovations, a group launched in 2017 to develop vaccines to stop epidemics. The program is now trying to regain its credibility by getting rich countries to distribute their donated vaccines through its own system, Baker said. But even this effort is not entirely successful as some countries are making their own deals to gain favorable publicity and political clout.

“Rich countries are trying to reap geopolitical benefits from bilateral dose sharing,” Baker noted.

So far, with the exception of China, donations are only a tiny fraction of what has been promised, an Associated Press tally of vaccines promised and delivered revealed.

Dr Christian Happi, infectious disease expert at the University of the Redeemer in Nigeria, said donations from rich countries are both insufficient and unreliable, especially since they not only took most of the supplies worldwide, but have also switched to immunizing children and are considering boosting.

Happi called on Africa, where 1.5% of the population is fully vaccinated, to increase its own vaccine manufacturing rather than relying on COVAX.

“We cannot just wait for them to find a solution,” he said.

COVAX is well aware of the problem. At its last board meeting at the end of June, health officials admitted they had failed to secure a fair split. But they still decided not to prevent donor countries from sourcing themselves.

In a subsequent meeting with partners, Gavi CEO Dr Seth Berkley said COVAX intended to honor the deals it had made with rich countries but would ask them in the future. “Adjust” their allocated doses to request fewer vaccines, according to a meeting participant. who spoke about the confidential call on condition of anonymity.

Among the reasons cited by Berkley for Gavi’s reluctance to sever or renegotiate contracts signed with rich countries was the potential risk to his balance sheet. In the past year, Britain alone has given over $ 860 million to COVAX.

June meeting notes show that Gavi revised COVAX’s original plan to distribute vaccines equally between rich and poor countries and proposed that poor countries receive about 75% of COVID-19 doses to the ‘to come up. Without the involvement of rich countries in COVAX, Gavi said “it would be difficult to make deals with some manufacturers.”

Responding to a request for comment from AP, Gavi said the initiative aimed to deliver more than 2 billion doses by early 2022 and described COVAX as “an unprecedented global effort.”

“The vast majority of COVAX supply will go to low and middle income countries,” Gavi said in an email about its latest supply forecast. For many countries, he said: “COVAX is the main, if not the only source of supply of COVID-19 vaccines.”

Spain’s donation to four Latin American countries – its first through COVAX – reflects how even rich countries with lots of vaccines donate a minimum. Spain, which injected 57 million doses to its own inhabitants, shipped 654,000 in the first week of August. The delivery totals 3% of the 22.5 million doses that Spain has eventually promised to COVAX.

Gavi said COVAX now has enough money and has pledged to donate to one day cover 30% of the population in the world’s poorest countries. But he has already made big promises.

In January, COVAX said it had “secure volumes” totaling 640 million doses to be delivered by July 2021, all under signed agreements, not donations. But last month, COVAX had only shipped 210 million doses, 40% of which were donated.

With COVAX sidelined, vaccine donations have become something of a political protest. China has already exported 770 million doses and last week announced its own goal of sending 2 billion doses to the rest of the world by the end of the year – exactly the same amount as COVAX’s original plan.

That’s way ahead of the rest of the world, according to the PA dose count. Britain delivered just 4.7 million, well below the 30 million promised, and the European Union gave 7.1 million and another 55 million through COVAX contracts.

“If the donors don’t come forward, the people who keep dying are our people,” said Strive Masiyiwa, the African Union’s special envoy for the COVID-19 vaccine supply.

The United States has so far delivered 111 million doses, less than half of what was promised. Several US lawmakers on both sides argued on Wednesday that the government should seize the diplomatic opportunity by more aggressively seeking credit for the doses it ships overseas.

“I think we should make vaccines available throughout the Middle East, but I also think we should have the American flag on every vial,” Representative Juan Vargas, a Democrat from California, said at a hearing. on the state of the pandemic in the Middle East.

Even the European Union’s foreign policy chief, Josep Borrell, recently denounced Europe’s delay in donations in geopolitical terms as a loss for China. US President Joe Biden, announcing the US donations that have finally been made, also described the doses as a way to counter “Russia and China influencing the world with vaccines.” The White House said the United States donated more than 110 million doses of the vaccine, some through COVAX.

In addition to its planned vaccine exports, China has announced plans to donate $ 100 million to COVAX to purchase more doses for developing countries.

“The key to strengthening vaccine cooperation and building the Great Immunization Wall is to ensure equitable access,” said Wang Xiaolong of the Chinese Foreign Ministry, speaking on Friday after China held a online forum on equitable vaccine distribution.

COVAX’s board of directors has agreed to go back to its basic assumptions about immunizing the world before the end of the year. At the top of her list: “An updated definition of fair and equitable access.”

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